Organization
DE-BORAH'S HOPE HOUSE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIAN ALSTON WALLACE (DIRECTOR)
(336) 908-1152
Entity
Organization
Contact information
Practice address
3113 MCCONNELL RD, GREENSBORO, NC 27405-9611
(336) 274-1988
(336) 834-2215
Mailing address
4701 FOX TROT RD, GREENSBORO, NC 27406-8235
(336) 908-1152
(336) 834-2215
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
MHL-041-1005
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
320800000X
—
NC
Enumeration date
02/04/2011
Last updated
02/04/2011
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